Pulmonary complications are the leading cause of illness and death in people with traumatic spinal cord injuries, both in the short- and long term after the injury. We have synthesized the available research regarding the effect of various treatment strategies for respiratory management of traumatic, high spinal cord injury within the first eight weeks after injury. We did not include pharmacological or surgical interventions in this report.
We found that:
Respiratory muscle training may improve maximal inspiratory pressure, but it is uncertain whether it has an effect on maximum expiratory pressure.
We do not know if mechanical or manual assisted cough has the best effects on lung function for patients in the acute phase.
We found no studies on postural drainage or non-invasive breathing support.
There is a lack of evidence on survival, adverse events, days on ventilator, patient days in hospitals, asthma or chronic obstructive pulmonary disease later on.
The evidence is sparse for treatment strategies for respiratory management of acute, traumatic, high spinal cord injury in hospital. Although respiratory difficulties are a major complication and frequent cause of death and prolonged hospital stay, no studies reported survival and patient days in hospital.
Studies in this field should involve several clinics or countries to get enough participants to identify effects of interventions.
Keywords: Spinal cord injuries; Breathing exercises; Respiratory therapy; Respiratory Muscles; Lung; Exercise therapy.
Copyright © 2017 by The Norwegian Institute of Public Health (NIPH).